DELIVERY PROCEDURE

 AIMS:- 

To allow natural progress & expulsion of fetus

Avoid minimal damage by counseling head & shoulder

Avoid minimal perineal damage

Episiotomy

Steps:- 1. Delivery of head

2. Delivery of Shoulder

3. Delivery of trunk

4. Cord clamping

1. Delivery of Head:-

Encourage Pt to bear down during contraction to facilitate descent of head to perineum.

Max diameter

The head that is biparietal diameter starches the vulval out let without any recession of the head is called “crowning of head”

Episiotomy is done before crowning of head.

Head is delivered by extension & after delivery face is wiped & mucus is aspirated by mouth & nose

Neck region should be exposed for coiled umbilical card.

2. Delivery of Shoulder:-

Head is hold gently by palm of both hands.

Pull the head gently to avoid injury on cervical & brachial plexus.

Delivery of ant. Shoulder take places by uterine contraction

When anterior shoulder is delivered & next uterine contraction head is guided upward the mother abdomen & posterior shoulder delivers out of perineum.

3. Delivery of trunk:-

After the delivery of shoulder four finger of each hand are inserted under the axils & the trunk is delivery by lateral flexion

4. Cord clamping:- 5 cm away from fetal abdomen card is cut & clamp

5. Immediate care of New born:-

After delivery head is slightly down wards to drain mucus liquar & debris from airways

Nose & pharynx are cleaned

Baby is given to mother for breast feeding as soon as possible

Apgar score at 1 to 5 mints